Andrea Christine Themistocleous, MSED, BCBA

Primary specialty

SpecialistTaxonomy code 174400000X

License

1752785 Issued in NY

Practice address

86 Smith LN
Centereach, NY 11720-3874

Phone

(917) 602-4103

NPI assigned

Jun 12, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1114289691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 SMITH LN",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203874",
            "telephone_number": "917-602-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 SMITH LN",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203874",
            "telephone_number": "917-602-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEMISTOCLEOUS",
        "first_name": "ANDREA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Miss",
        "credential": "MSED, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1-07-3692",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1752785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Danielle Tahlor, RDN, CDN
• Rachel A Tassone-Logatto, MS CCC-SLP
• Gabriella Marie Teixeira
• Brenda Terney
• Nicole Tersigni
• Joseph Thomas, MD
• Noreen Theresa Thompson, RN
• Toro Mental Health Counseling
• Byane Laurell Torres, DOULA
• Jessica Torres

• Specialist in Centereach, NY
• Providers in Centereach, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.